Enamel Solubility Research Articles

The effect of fluoridated and iodized salt consumption by schoolchildren on acid solubility of permanent teeth enamel

Aim. To study the acid solubility of enamel based on calcium and phosphorus from the enamel surface layer to the acid biopsy and test of enamel resistance indicators in school-age children in the presence of biogeochemical fluoride and iodide deficiency, as well as the changes in these parameters amid the 3-year fluoridated and iodized salt consumption.Methods. Enamel solubility on calcium and phosphorus was evaluated based on calcium and phosphorus release from surface layer of permanent teeth enamel into acid biopsy. Test of enamel resistance was determined by V.R. Okushko method. The color intensity was assessed using standard 10-point blue color scale.Results.. The effect of 3-year consumption of fluoridated and iodized (300±50 mg/kg fluoride, 40±10 mg/kg iodide) salt on the acid solubility of permanent teeth enamel in 155 schoolchildren, born and living in conditions of biogeochemical deficiency of fluoride (fluoride content in water 0.02-0.08 mg/l) and iodide (iodide content in water 3.38±5.07 g/l) was studied. Consumption of fluoridated and iodized salt during 36 months contributed to the maximal calcium and phosphorus release from the enamel surface layer to acid biopsy during the study period. At the end of the follow-up period in the main group of schoolchildren in relation to the control group, the calcium release from the enamel surface layer to acid biopsy was higher by 131.3%, phosphorus - by 114.5%.Conclusion. The presence of fluoridated and iodized salt in the children diet leads to a decrease in the solubility of permanent teeth enamel and, consequently, to increase in resistance to acids.

Dental materials. Amorphous intergranular phases control the properties of rodent tooth enamel.

Dental enamel, a hierarchical material composed primarily of hydroxylapatite nanowires, is susceptible to degradation by plaque biofilm-derived acids. The solubility of enamel strongly depends on the presence of Mg(2+), F(-), and CO3(2-). However, determining the distribution of these minor ions is challenging. We show—using atom probe tomography, x-ray absorption spectroscopy, and correlative techniques—that in unpigmented rodent enamel, Mg(2+) is predominantly present at grain boundaries as an intergranular phase of Mg-substituted amorphous calcium phosphate (Mg-ACP). In the pigmented enamel, a mixture of ferrihydrite and amorphous iron-calcium phosphate replaces the more soluble Mg-ACP, rendering it both harder and more resistant to acid attack. These results demonstrate the presence of enduring amorphous phases with a dramatic influence on the physical and chemical properties of the mature mineralized tissue.

Enamel solubility potential of commercially available soft drinks and fruit juices in Saudi Arabia

Abstract Aim: To evaluate pH, titratable acidity and in vitro enamel solubility potential of different commercially available soft drinks and fruit juices in Saudi Arabia. Methods: Thirty two popular soft drinks and juices were tested for their enamel solubility potential. In addition, bottled drinking water was used as the control. Each drink was evaluated for its pH, titratable acidity which was measured by adding 0.1 N NaOH (sodium hydroxide) to a chosen end point. In addition, one enamel slice was immersed in each test beverage and percentage weight loss in the enamel slice was calculated after intervals of 6 and 24 h. Results: The pH of all the test drinks ranged from 1.64 to 3.89. Mean pH of 2.84 in soft drinks was significantly lower than in the fruit juices. There was a significant difference between them for percentage weight loss after 6 and 24 h immersion with carbonated beverages causing greater enamel loss than the fruit juices. Colas and non-colas did not differ statistically for pH, titratable acidity and percentage weight loss of enamel slices. Conclusions: The pH of all the test drinks was below the critical pH of 5.5 for enamel dissolution. Carbonated drinks were observed to have more enamel solubility potential than fruit juices while regular or diet variants and colas or non-colas had comparable solubility potential.

The role of yoghurt on dental erosion

Dental erosion is defined as irreversible loss of dental hard tissue, caused by acid condition in the oral cavity without bacterial involvement. One of the signs of dental erosion is calcium dissolution of the enamel. Yoghurt is a fermented beverage that has low pH level due to lactic acid. The aim of this study was to measure the solubility of calcium enamel after soaking in yoghurt for 12 and 18 hours. Twenty-four premolars were divided into 4 groups. Group A and B were soaked in milk for 12 and 18 hours; group C and D were soaked in yoghurt for 12 and 18 hours. Atomic Absorption Spectrophotometer (AAS) was used to measure the solubility of calcium from each sample. Data were analyzed using one-way ANOVA and LSD (p < 0.05). This study indicated that soaking premolars in yoghurt for 18 hours has greater enamel calcium dissolution than in yoghurt for 12 hours. It can be concluded that prolonged soaking premolars in yoghurt will increase the calcium enamel dissolution.

Kelarutan kalsiumemail pada saliva penderita tuna netra (Dissolution of enamel calcium in saliva of patients with visual impairment)

Patients with visual impairment experienced debris, calculus and a high index of oral hygiene. Low salivary flow anddifficulty in cleaning the oral cavity in patients with visual impairment caused high accumulation of plaque that causesa decrease in the pH of saliva. Low pH of saliva affects the balance of the composition of inorganic email. Calcium isthe largest inorganic content of the email, thus dissolving calcium email can be an indication of enameldemineralization. This study aimed to determine the solubility of calcium in saliva of blind patients, and salivary pHrelationship with the solubility of calcium. This experimental laboratory study used saliva taken from 8 blind patientsand artificial saliva as a medium of enamel pieces soaking for 24 hours. Dissolved calcium levels were measured byatomic absorption spectrophotometer. The results showed that the solubility of calcium in the saliva of blind patientsgreater than the control group (p<0.05). Pearson correlation test demonstrate the relationship between salivary pHand solubility of calcium enamel, so the lower the pH the greater enamel calcium dissolution. It was concluded that themagnitude of the solubility of calcium enamel due to decreased of salivary pH.

Enamel Solubility and Depth of Demineralization with Laser Bleaching and the Impact of CPP-ACP: An Optico-chemical Analysis

Enamel Solubility and Depth of Demineralization with Laser Bleaching and the Impact of CPP-ACP: An Optico-chemical Analysis

The cariostatic mechanisms of fluoride

This article discusses the possible cariostatic mechanisms of the action of fluoride. In the past, fluoride inhibition of caries was ascribed to reduced solubility of enamel due to incorporation of fluoride (F-) into the enamel minerals. The present evidence from clinical and laboratory studies suggests that the caries-preventive mode of action of fluoride is mainly topical. There is convincing evidence that fluoride has a major effect on demineralisation and remineralisation of dental hard tissue. The source of this fluoride could either be fluorapatite (formed due to the incorporation of fluoride into enamel) or calcium fluoride (CaF2)-like precipitates, which are formed on the enamel and in the plaque after application of topical fluoride. Calcium fluoride deposits are protected from rapid dissolution by a phosphate -protein coating of salivary origin. At lower pH, the coating is lost and an increased dissolution rate of calcium fluoride occurs. The CaF2, therefore, act as an efficient source of free fluoride ions during the cariogenic challenge. The current evidence indicates that fluoride has a direct and indirect effect on bacterial cells, although the in vivo implications of this are still not clear. A better understanding of the mechanisms of the action of fluoride is very important for caries prevention and control. The effectiveness of fluoride as a cariostatic agent depends on the availability of free fluoride in plaque during cariogenic challenge, i.e. during acid production. Thus, a constant supply of low levels of fluoride in biofilm/saliva/dental interference is considered the most beneficial in preventing dental caries.

Numerical Modelling of Tooth Enamel Subsurface Lesion Formation Induced by Dental Plaque

Using a one-dimensional mathematical model that couples tooth demineralisation and remineralisation with metabolic processes occurring in the dental plaque, two mechanisms for subsurface lesion formation were evaluated. It was found that a subsurface lesion can develop only as the result of alternating periods of demineralisation (acid attack during sugar consumption) and remineralisation (resting period) in tooth enamel with uniform mineral composition. It was also shown that a minimum plaque thickness that can induce an enamel lesion exists. The subsurface lesion formation can also be explained by assuming the existence of a fluoride-containing layer at the tooth surface that decreases enamel solubility. A nearly constant thickness of the surface layer was obtained with both proposed mechanisms. Sensitivity analysis showed that surface layer formation is strongly dependent on the length of remineralisation and demineralisation cycles. The restoration period is very important and the numerical simulations support the observation that often consumption of sugars is a key factor in caries formation. The calculated profiles of mineral content in enamel are similar to those observed experimentally. Most probably, both studied mechanisms interact in vivo in the process of caries development, but the simplest explanation for subsurface lesion formation remains the alternation between demineralisation and remineralisation cycles without any pre-imposed gradients.

Evaluation of acquired acid resistance of enamel surrounding orthodontic brackets irradiated by laser and fluoride application

Demineralization of enamel around orthodontic brackets is a clinical problem which can lead to some esthetic concerns like white spot lesions. The aim of this in vitro study was to evaluate the effect of the Er, Cr:YSGG laser and fluoride application on the acid resistance of enamel adjacent to orthodontic brackets. A total of 60 healthy, permanent, human premolars were selected and bonded with brackets, then they were randomly assigned to four groups (n = 15): topical APF gel (1.23% F, pH 3.5, for 4 min); Er,Cr:YSGG laser (P:0.25 W, E:12.5 mJ, RR:20 Hz, PD:140 μs, 11% air, without water, for 10 s); fluoride + laser group (F + L), and control group (C). All specimens were demineralized for 10 days in a 0.2 M acetate buffer solution, and the calcium content were subsequently determined with atomic absorption spectrometry. There were significant differences between the calcium content of F + L and F group in comparison to control group. The least concentration of calcium was seen in F + L group, and the most value was observed in C group. Combination of Er, Cr:YSGG laser with fluoride and fluoride alone decreased enamel solubility significantly more than laser alone. In addition, combination of laser and fluoride leads to less consumption of fluoride amount. And patients can use it at the beginning of treatment instead of daily use of fluoride. So we suggest using it in preventing enamel demineralization around orthodontic brackets.

Effects of Er:YAG Laser Irradiation and Topical Fluoride Application on Inhibition of Enamel Demineralization

ABSTRACT Objective: The aim of this study was to evaluate the effect of the Er:YAG laser and acidulated phosphate fluoride application on enamel solubility around orthodontic brackets via atomic absorption spectrometry. Materials and Methods: Twenty freshly extracted upper premolar teeth were divided into 2 halves. Each half was covered with a nail varnish, excluding 1 mm (width) of space around each side of the bracket base. Orthodontic brackets were bonded in the center of the isolated area. Four groups were generated. The first group was the control group, and no treatment was performed. In group II (F), only fluoride was applied. Groups III and IV were laser and fluoride combination groups. In Group III (LF), fluoride was applied to the laser-irradiated surface, whereas laser irradiation was performed on the fluoridated enamel surface in Group IV (FL group). Afterwards, samples were demineralized in an acidic solution for 96 hours, and calcium assessment was performed using atomic absorption spectrome...

Surface remineralization potential of casein phosphopeptide-amorphous calcium phosphate on enamel eroded by cola-drinks: An in-situ model study.

Aim:The aim of this study was to investigate the remineralization potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on enamel eroded by cola drinks.Subjects and Methods:A total of 30 healthy subjects were selected from a random sample of 1200 children and divided into two groups of 15 each wherein calcium and phosphorus analyses and scanning electron microscope (SEM) analysis was carried out to investigate the remineralization of enamel surface. A total of 30 non-carious premolar teeth were selected from the human tooth bank (HTB) to prepare the in-situ appliance. Three enamel slabs were prepared from the same. One enamel slab was used to obtain baseline values and the other two were embedded into the upper palatal appliances prepared on the subjects’ maxillary working model. The subjects wore the appliance after which 30 ml cola drink exposure was given. After 15 days, the slabs were removed and subjected to respective analysis.Statistical Analysis Used:Means of all the readings of soluble calcium and phosphorous levels at baseline,post cola-drink exposure and post cpp-acp application were subjected to statistical analysis SPSS11.5 version. Comparison within groups and between groups was carried out using ANOVA and F-values at 1% level of significance.Results:Decrease in calcium solubility of enamel in the CPP-ACP application group as compared to post-cola drink exposure group (P < 0.05) was seen. Distinctive change in surface topography of enamel in the post-CPP-ACP application group as compared to post-cola drink exposure group was observed.Conclusion:CPP-ACP significantly promoted remineralization of enamel eroded by cola drinks as revealed by significant morphological changes seen in SEM magnification and spectrophotometric analyses.

Potential Mechanism for the Laser-Fluoride Effect on Enamel Demineralization

Laser-induced prevention of dental caries has been studied extensively. However, the cariostatic mechanisms of a combined fluoride-laser treatment are not well-understood. Using micro- computed tomography (micro-CT), we quantified the effect of fluoride and/or Er:YAG laser treatment on enamel demineralization. The mean mineral loss (%/V) for each group was 4,870 ± 1,434 (fluoride followed by laser treatment), 6,341 ± 2,204 (laser treatment), 7,669 ± 2,255 (fluoride treatment), and 10,779 ± 2,936 (control). The preventive effect of the laser (p < 0.001) and fluoride (p = 0.010) treatment was statistically significant. Characterized by micro-x-ray diffraction (XRD) analysis, the significant contraction in the a-axis after both laser and combined laser/fluoride treatment was revealed (both p < 0.05). In conclusion, subablative low-energy Er:YAG laser irradiation following fluoride treatment may instantaneously transform enamel hydroxyapatite into fluoridated hydroxyapatite to reduce enamel solubility as a preventive treatment for enamel demineralization.

Quantitative Proteomic Analysis of the Effect of Fluoride on the Acquired Enamel Pellicle

The acquired enamel pellicle (AEP) is a thin film formed by the selective adsorption of salivary proteins onto the enamel surface of teeth. The AEP forms a critical interface between the mineral phase of teeth (hydroxyapatite) and the oral microbial biofilm. This biofilm is the key feature responsible for the development of dental caries. Fluoride on enamel surface is well known to reduce caries by reducing the solubility of enamel to acid. Information on the effects of fluoride on AEP formation is limited. This study aimed to investigate the effects of fluoride treatment on hydroxyapatite on the subsequent formation of AEP. In addition, this study pioneered the use of label-free quantitative proteomics to better understand the composition of AEP proteins. Hydroxyapatite discs were randomly divided in 4 groups (n = 10 per group). Each disc was exposed to distilled water (control) or sodium fluoride solution (1, 2 or 5%) for 2 hours. Discs were then washed and immersed in human saliva for an additional 2 hours. AEP from each disc was collected and subjected to liquid chromatography electrospray ionization mass spectrometry for protein identification, characterization and quantification. A total of 45 proteins were present in all four groups, 12 proteins were exclusively present in the control group and another 19 proteins were only present in the discs treated with 5% sodium fluoride. Relative proteomic quantification was carried out for the 45 proteins observed in all four groups. Notably, the concentration of important salivary proteins, such as statherin and histatin 1, decrease with increasing levels of fluoride. It suggests that these proteins are repulsed when hydroxyapatite surface is coated with fluoride. Our data demonstrated that treatment of hydroxyapatite with fluoride (at high concentration) qualitatively and quantitatively modulates AEP formation, effects which in turn will likely impact the formation of oral biofilms.

Quantitative Determination of Inorganic Constituents in Saliva and their Relationship with Dental Caries Experience in Children

Background: Saliva is one of the most important factor in regulating oral health, with flow rate and composition changing throughout development and during disease. Saliva can affect incidence of dental caries in four general ways, firstly as a mechanical cleansing, secondly by reducing enamel solubility by means of calcium, phosphate and fluoride, thirdly by buffering and neutralizing the acids produced by cariogenic organisms and finally by anti-bacterial activity. Thus, the present study aimed to assess the levels of salivary immunoglobulin A (IgA), immunoglobulin G (IgG), proteins, calcium, inorganic phosphorous and alkaline phosphatase levels in caries free and caries active children. Material and methods: Forty school children in the age group of 12-15 years with full complement of permanent dentition except third molars were included by stratified random sampling method. They were divided into two groups of 20 each based on DMFS score, Group I – Caries free (DMFS score=0) and Group II – Caries active (DMFS score ≥ 10). Unstimulated midmorning saliva samples were collected and analyzed colorimetrically and by radial immunodiffusion method for constituents of saliva under study. Results: The mean salivary IgA levels in children in Group-I (caries free children) was 10.63±2.85 mg/dl which was statistically higher as compared to caries active children in Group-II (8.50 ± 1.43 mg/dl). The mean salivary protein level in children of Group-II was statistically higher at 3.28 ± 0.12 mg/dl as compared to Group-I (2.89 ± 0.11 mg/dl). Conclusion: An inverse relationship was noticed between the salivary IgA levels and dental caries experience and higher salivary protein levels were associated with high caries experience whereas no significant difference was observed in levels of calcium, inorganic phosphorous, alkaline phosphatase and IgG in saliva samples of children with and without dental caries.

Effect of Stannous Fluoride and Dilute Hydrofluoric Acid on Early Enamel Erosion over Time in vivo

Recent experimental in vivo studies have shown that aqueous solutions of stannous fluoride (SnF₂) and hydrofluoric acid (HF) can reduce enamel solubility after 5 min. The aim of this study was to evaluate the longer-term protective effect of SnF₂ (0.78%, pH 2.9) and HF (0.2%, pH 2.0) (both ∼0.1 mol/l F) using the same experimental model. Labial surfaces of healthy anterior teeth (all four surfaces when possible, otherwise a pair of surfaces) in 103 subjects (n = 399 teeth) were exposed to citric acid (0.01 mol/l, pH 2.7). The acid was applied using a peristaltic pump (5 ml, 6 ml/min) and was collected in coded test tubes (etch I). The test solutions were then applied to the same surfaces of the teeth (1 min, 6 ml/min). After either 1, 7, 14 or 28 days, citric acid was again applied to the same surfaces and subsequently collected (etch II). Enamel solubility was examined by assessment of calcium concentration in etch I and etch II solutions using atom absorption spectroscopy. Median values were calculated for all time periods and statistical analysis was carried out using the Wilcoxon signed-ranks test. Results showed that HF reduced enamel solubility by 54 and 36% after 1 and 7 days, respectively. After 14 and 28 days, there was no longer any effect. SnF₂ showed no protective effect after the first day. Given these results, repeated application of HF and especially SnF₂ may be necessary to improve the protective effect of these fluorides, and this requires further testing.

Dental enamel irradiated with infrared diode laser and photo-absorbing cream: part 2--EDX study.

The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (micro-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive micro-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (lambda = 810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using micro-EDX after two sets of treatments and pH cycling cariogenic challenges. The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. micro-EDX may be able to detect compositional changes in mineral phases of lased enamel under cariogenic challenge. Our results suggest that with a combined laser and photo-absorbing agent (CL) treatment, there was a possible disorganization of organic content in the tooth enamel with hydroxyapatite crystal reordering and reorganization.

Dental enamel irradiated with infrared diode laser and photoabsorbing cream: Part 1 -- FT-Raman Study.

The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm(2) for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). The FT-Raman technique may be suitable for detecting compositional and structural changes occurring in mineral phases and organic phases of lased enamel under cariogenic challenge.

Slow-release fluoride devices: a literature review.

Although the prevalence of caries has decreased dramatically over the past decades, it has become a polarised disease, with most of subjects presenting low caries levels and few individuals accounting for most of the caries affected surfaces. Thus it become evident for the need of clinical approaches directed at these high-risk patients, in order to overcome problems related to compliance and low attendance at dental care centres. Slow-release fluoride devices were developed based on the inverse relationship existing between intra-oral fluoride levels and dental caries experience. The two main types of slow-release devices – copolymer membrane type and glass bead – are addressed in the present review. A substantial number of studies have demonstrated that these devices are effective in raising intra-oral F concentrations at levels able to reduce enamel solubility, resulting in a caries-protective effect. Studies in animals and humans demonstrated that the use of these devices was able to also protect the occlusal surfaces, not normally protected by conventional fluoride regimens. However, retention rates have been shown to be the main problem related to these devices and still requires further improvements. Although the results of these studies are very promising, further randomised clinical trials are needed in order to validate the use of these devices in clinical practice. The concept of continuously providing low levels of intra-oral fluoride has great potential for caries prevention in high caries-risk groups.

Low-fluence CO2 laser irradiation decreases enamel solubility

This study investigated whether subablative-pulsed CO2 laser (10.6 μm) irradiation, using fluences lower than 1 J/cm2, was capable of reducing enamel acid solubility. Fifty-one samples of bovine dental enamel were divided into three groups: control group, which was not irradiated (CG); group laser A (LA) irradiated with 0.3 J/cm2; and group laser B (LB) irradiated with 0.7 J/cm2. After irradiation, the samples were subjected to demineralization in an acetate buffer solution and were then analyzed by SEM. A finite-element model was used to calculate the temperature increase. The calcium and phosphorous content in the demineralization solution were measured with an ICP-OES. ANOVA and the t-test pairwise comparison (p < 0.016) revealed that LB showed significantly lower mean Ca and P content values in the demineralization solution than other groups. A reduction in the enamel solubility can be obtained with pulsed CO2 laser irradiation (0.7 J/cm2, 135 mJ/pulse, 74 Hz, 100 μs) without any surface photomodification and a less than 2°C temperature increase at a 3-mm depth from the surface.

Low-fluence CO2 laser irradiation decreases enamel solubility

This study investigated whether subablative-pulsed CO2 laser (10.6 μm) irradiation, using fluences lower than 1 J/cm2, was capable of reducing enamel acid solubility. Fifty-one samples of bovine dental enamel were divided into three groups: control group, which was not irradiated (CG); group laser A (LA) irradiated with 0.3 J/cm2; and group laser B (LB) irradiated with 0.7 J/cm2. After irradiation, the samples were subjected to demineralization in an acetate buffer solution and were then analyzed by SEM. A finite-element model was used to calculate the temperature increase. The calcium and phosphorous content in the demineralization solution were measured with an ICP-OES. ANOVA and the t-test pairwise comparison (p < 0.016) revealed that LB showed significantly lower mean Ca and P content values in the demineralization solution than other groups. A reduction in the enamel solubility can be obtained with pulsed CO2 laser irradiation (0.7 J/cm2, 135 mJ/pulse, 74 Hz, 100 μs) without any surface photomodification and a less than 2°C temperature increase at a 3-mm depth from the surface.